Regular training is the strongest predictor of treatment success with pelvic-floor muscle training

This study investigated what can predict treatment success of pelvic-floor muscle training (PFMT) for stress urinary incontinence. Authors reported that short-term result, regular PFMT training and older age can predict treatment success with PFMT at 1 year.

Stress urinary incontinence affects between 10 and 35% of women. Pelvic-floor muscle training (PFMT) is often the first, and most widely used, treatment for stress urinary incontinence. Exercising the pelvic muscles improves their strength and coordination, which is important to prevent urine leakage. However, not all women respond to PFMT equally. Identifying factors that affect treatment outcomes with PFMT has become increasingly important to help optimize therapy for patients early on.

This study examined factors important for the success of PFMT in 169 women with stress urinary incontinence. Women underwent either an internet-based training program for PFMT or a PFMT program delivered by mail. Both programs consisted of PFMT of increasing intensity 3 times per day for 3 months. Treatment success was measured using different urinary incontinence questionnaires. Participants were followed for 1 year.

Overall, 77% of women reported treatment success on at least 1 of the 3 questionnaires used. 23% of women reported treatment success in all 3 questionnaires. Of the women who reported treatment success at 4 months, 55 to 76% (depending on the questionnaire used) were still successful at 1 year. Of the women who did not report success at the 4-month follow-up, 20 to 31% succeeded at the 1-year follow-up.

A successful result at 4 months reliably predicted treatment success at 1 year. Regular PFMT training increased the likelihood of treatment success at 1 year 2.32-fold. Women with slightly higher age were also 6% more likely to be successful at 1 year. The average age in the success group was 51 to 53.7 years (depending on the questionnaire used). The average age in the treatment failure group ranged from 46 to 49.3 years. 

Authors reported that regular PFMT training was the strongest predictor of treatment success at 1 year.

Treatment success in this study was only based on self-reported questionnaires (subjective measure). Further studies involving physical examinations and stress tests (objective measures) are needed to confirm these findings.